Active NPI
Jennifer L Johnson, RN
- Registered Nurse
- Canton, MS
National Provider Identifier
1992023378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 906486
- Practice address
- 993 Dry Creek Rd
Canton, MS 39046-8686 - Phone
- (601) 573-7582
- NPI assigned
- May 11, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 906486 | MS | Primary |
Addresses
Primary practice location
993 Dry Creek Rd
Canton, MS 39046-8686
Mailing address
993 Dry Creek Rd
Canton, MS 39046-8686
Phone (601) 573-7582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569456000000",
"number": "1992023378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "993 DRY CREEK RD",
"city": "CANTON",
"state": "MS",
"postal_code": "390468686",
"telephone_number": "601-573-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "993 DRY CREEK RD",
"city": "CANTON",
"state": "MS",
"postal_code": "390468686",
"telephone_number": "601-573-7582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JENNIFER",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-11",
"last_updated": "2019-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MS",
"license": "906486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.